DR. LUIS M BENALCAZAR M.D.
NPI 1801878269
Internal Medicine in Elizabeth, NJ

Q: What is Luis Benalcazar's NPI number?

The NPI number for Luis Benalcazar is 1801878269. It was assigned to this individual provider in the NPPES registry on November 18, 2005.

Q: What is Luis Benalcazar's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Luis Benalcazar was last updated on February 18, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since November 18, 2005PECOS EnrolledAccepts Medicare Assignment

624 NEWARK AVE, ELIZABETH, NJ 07208(908) 353-3626(908) 353-3625 Get Directions Write a Review

NPPES record last updated: February 18, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 18, 2025, Dec 1, 2017 (2 updates tracked since 2017).

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About Dr. Luis M Benalcazar M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. LUIS M BENALCAZAR M.D. (NPI 1801878269) is an individual internal medicine provider in Elizabeth, New Jersey, licensed in New Jersey (25MA07504600) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS, is affiliated with Trinitas Regional Medical Center, and is a graduate of Ponce School Of Medicine (2000).

NPPES Registry Identity

NPI1801878269

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameDR. LUIS M BENALCAZARCredential: M.D.

Location Address624 NEWARK AVEElizabeth, NJ 07208-3539

Mailing Address624 Newark AveElizabeth, NJ 07208-3539 · (908) 353-3626 · Fax (908) 353-3625

Phone(908) 353-3626

Fax(908) 353-3625

Sole ProprietorYes

Medical School CMSPonce School Of MedicineGraduated 2000

Enumeration DateNovember 18, 2005

Last NPPES UpdateFebruary 18, 20252 updates tracked since enumeration

NPPES CertifiedFebruary 18, 2025

✔ NPI 1801878269 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Licenses✔ Licensed in NJ · 25MA07504600✔ Licensed in NY · 2325031

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

624 NEWARK AVE, Elizabeth, NJ 07208

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Other Identifiers 1

Medicaid0028410NJ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Luis M Benalcazar M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6002719762

PECOS Enrollment IDI20040129000881, I20230217002803

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 17

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

237 services86 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

112 services54 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

59 services37 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

58 services58 patients

Ultrasound of leg arteries or artery grafts 93925

An ultrasound of leg arteries or artery grafts is a non-invasive imaging test. It uses high-frequency sound waves to capture live images from inside your body, specifically your leg arteries or grafts. This helps in detecting any blockages or abnormalities.

36 services36 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

34 services19 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

29 services26 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.

29 services29 patients

Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts 93978

This procedure involves using sound waves to create images of your aorta, vena cava, groin vessels, or bypass grafts. It helps to detect abnormalities or blockages, ensuring your blood flows smoothly. It's painless and non-invasive.

26 services26 patients

Ultrasound study of arm or leg veins with compression and maneuvers 93970

An ultrasound study of arm or leg veins with compression and maneuvers is a non-invasive procedure that uses sound waves to create images of your veins. This helps identify blood clots or other vein problems. During the procedure, pressure is applied to the veins and certain movements are performed to assess blood flow.

24 services24 patients

Limited ultrasound scan of abdomen 76705

A limited ultrasound scan of the abdomen is a non-invasive imaging test. It uses sound waves to produce images of the abdominal organs such as the liver, gallbladder, spleen, pancreas, and kidneys. This helps to identify any abnormalities or issues.

19 services19 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

17 services11 patients

Ultrasound of both sides of head and neck blood flow 93880

An ultrasound of the head and neck blood flow is a safe, non-invasive procedure that uses sound waves to create images of blood vessels. It helps detect abnormalities like blockages or clots, ensuring optimal blood flow.

15 services15 patients

Ultrasound of abdomen and pelvis artery and vein blood flow 93976

An ultrasound of your abdomen and pelvis arteries and veins is a non-invasive procedure that uses sound waves to create images of your blood vessels. This helps in assessing the flow of blood, identifying blockages, or detecting other abnormalities. It's a safe, painless process.

14 services14 patients

Ultrasound scan of head and neck soft tissue 76536

An ultrasound scan of the head and neck soft tissue is a non-invasive procedure that uses sound waves to create images of the soft tissues in these areas. It helps identify any abnormalities or issues, such as tumors, cysts, or infections. It's painless and doesn't involve radiation.

13 services12 patients

Complete ultrasound scan of pelvis 76856

A complete ultrasound scan of the pelvis is a safe, non-invasive imaging procedure. It uses sound waves to create pictures of your lower abdomen area, helping doctors to evaluate and diagnose any potential issues. It's painless and usually takes about 30 minutes.

13 services13 patients

Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment G0402

An Initial Preventive Physical Examination, also known as a "Welcome to Medicare" visit, is a one-time, face-to-face visit during your first 12 months of Medicare enrollment. It includes a review of your health, as well as education and counseling about preventive services and further screenings.

12 services12 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Trinitas Regional Medical Center

Acute Care Hospitals · Elizabeth, NJ

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310027

Location225 Williamson StreetElizabeth, NJ 07207 · Union County

Emergency services Birthing friendly

Raritan Bay Medical Center

Acute Care Hospitals · Perth Amboy, NJ

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310039

Location530 New Brunswick AvePerth Amboy, NJ 08861 · Middlesex County

Emergency services Birthing friendly

Hospital Buen Samaritano

Acute Care Hospitals · Aguadilla, PR

OwnershipVoluntary non-profit - Private

CMS Certification Number400079

LocationCarr Est Pr 460 Km 0 1 Bo Caimital AltoAguadilla, PR 00603 · Aguadilla County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07208 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$144.86 typical visit price

range $63.84 – $190.92

Typical copayment $36.21 (range $15.96 – $47.73)

Most-billed visit code 99204

Established Patient

$111.57 typical visit price

range $20.97 – $155.92

Typical copayment $27.89 (range $5.24 – $38.98)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 7

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

8 suppliers26 claims54 services$6.58 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

6 suppliers17 claims20 services$1.12 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

1 supplier17 claims17 services$12.29 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

2 suppliers29 claims29 services$53.16 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

1 supplier12 claims12 services$25.48 avg. paid by Medicare

Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613

DME-Drugs Administered Through DME · category DG006N

1 supplier14 claims1,992 services$0.03 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRIAN ADAMES

Physician Assistant

624 NEWARK AVE
ELIZABETH, NJ 07208

Union County (908) 353-3626

ADANESA MOLINA

Nurse Practitioner (Adult Health)

624 NEWARK AVE
ELIZABETH, NJ 07208

Union County (732) 353-3626

DR. ADA M ANDINO RN, APN

Nurse Practitioner (Family)

624 NEWARK AVE
ELIZABETH, NJ 07208

Union County (908) 353-3626

CENTER FOR DIAGNOSIS AND TREATMENT, LLC

Internal Medicine

624 NEWARK AVE
ELIZABETH, NJ 07208

Union County (908) 353-3626

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Luis Benalcazar's NPI number?

The NPI number for Luis Benalcazar is 1801878269. It was assigned to this individual provider in the NPPES registry on November 18, 2005.

Where is Luis Benalcazar located?

Luis Benalcazar practices at 624 Newark Ave, Elizabeth, NJ 07208. The listed phone number is (908) 353-3626.

What is Luis Benalcazar's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Luis Benalcazar enrolled in Medicare?

Yes. Luis Benalcazar is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Luis Benalcazar accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Luis Benalcazar as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Luis Benalcazar affiliated with any hospitals?

According to CMS data, Luis Benalcazar is affiliated with Trinitas Regional Medical Center, Raritan Bay Medical Center and Hospital Buen Samaritano.

When was this NPI record last updated?

The NPPES record for Luis Benalcazar was last updated on February 18, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.